OCTA in neurodegenerative optic neuropathies: emerging biomarkers at
the eye–brain interface

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Abstract

OCTA imaging in optic neuropathies.

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Alzheimer's disease and Parkinson's disease.

Robert L. Nussbaum, Christopher Ellis (2003)

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A review of optical coherence tomography angiography (OCTA)

Talisa de Carlo, André Romano, Nadia K. Waheed … (2015)

Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging technique that generates volumetric angiography images in a matter of seconds. This is a nascent technology with a potential wide applicability for retinal vascular disease. At present, level 1 evidence of the technology’s clinical applications doesn’t exist. In this paper, we introduce the technology, review the available English language publications regarding OCTA, and compare it with the current angiographic gold standards, fluorescein angiography (FA) and indocyanine green angiography (ICGA). Finally we summarize its potential application to retinal vascular diseases. OCTA is quick and non-invasive, and provides volumetric data with the clinical capability of specifically localizing and delineating pathology along with the ability to show both structural and blood flow information in tandem. Its current limitations include a relatively small field of view, inability to show leakage, and proclivity for image artifact due to patient movement/blinking. Published studies hint at OCTA’s potential efficacy in the evaluation of common ophthalmologic diseases such age related macular degeneration (AMD), diabetic retinopathy, artery and vein occlusions, and glaucoma. OCTA can detect changes in choroidal blood vessel flow and can elucidate the presence of choroidal neovascularization (CNV) in a variety of conditions but especially in AMD. It provides a highly detailed view of the retinal vasculature, which allows for accurate delineation of the foveal avascular zone (FAZ) in diabetic eyes and detection of subtle microvascular abnormalities in diabetic and vascular occlusive eyes. Optic disc perfusion in glaucomatous eyes is notable as well on OCTA. Further studies are needed to more definitively determine OCTA’s utility in the clinical setting and to establish if this technology may offer a non-invasive option of visualizing the retinal vasculature in detail.

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Microvascular network alterations in the retina of patients with Alzheimer's disease.

Tien-Yin Wong, Po-Chuan Chen, Dennis Seow … (2014)

Although cerebral small-vessel disease has been implicated in the development of Alzheimer's disease (AD), the cerebral microcirculation is difficult to visualize directly in vivo. Because the retina provides a noninvasive window to assess the microcirculation, we determined whether quantitatively measured retinal microvascular parameters are associated with AD. We conducted a case-control study (case:control matching ≈ 1:2). Retinal photographs were analyzed using a computer program, and a spectrum of quantitative retinal microvascular parameters (caliber, fractal dimension, tortuosity, and bifurcation) were measured. Logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval for AD adjusting for age, gender, ethnicity, smoking, hypertension, diabetes, hypercholesterolemia, and history of myocardial infarction. We included 136 demented patients with AD and 290 age-gender-race-matched controls. Persons with narrower venular caliber (OR per standard deviation [SD] decrease, 2.01 [1.27-3.19]), decreased arteriolar and venular fractal dimension (OR per SD decrease 1.35 [1.08-1.68], 1.47 [1.17-1.84], respectively) and increased arteriolar and venular tortuosity (OR per SD increase, 1.84 [1.40-2.31], 1.94 [1.48-2.53], respectively) were more likely to have AD. These associations still persisted when only AD cases without a history of cerebrovascular disease were included. Patients with AD have altered microvascular network in the retina (narrower retinal venules and a sparser and more tortuous retinal vessels) compared with matched nondemented controls. These changes in retinal microvasculature may reflect similar pathophysiological processes in cerebral microvasculature in the brains of patients with AD. Copyright © 2014 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

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Contributors

Samuel Asanad:

ORCID: https://orcid.org/0000-0002-7556-0155

Isa Mohammed

Alfredo A. Sadun

Osamah J. Saeedi

Journal

Journal ID (nlm-ta): Ther Adv Ophthalmol

Journal ID (iso-abbrev): Ther Adv Ophthalmol

Journal ID (publisher-id): OED

Journal ID (hwp): spoed

Title: Therapeutic Advances in Ophthalmology

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Electronic): 2515-8414

Publication date (Electronic): 27 August 2020

Publication date Collection: Jan-Dec 2020

Volume: 12

Electronic Location Identifier: 2515841420950508

Affiliations

[1-2515841420950508]Department of Ophthalmology and Visual Sciences, University of Maryland Eye Associates, University of Maryland Medical Center and University of Maryland School of Medicine, 419 W. Redwood St., Baltimore, MD 21201, USA

[2-2515841420950508]Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA

[3-2515841420950508]Doheny Eye Center, Los Angeles, CA, USA; Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

[4-2515841420950508]Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA

Author notes

[*] sasanad@ 123456som.umaryland.edu samuelasanad@ 123456gmail.com

Author information

Samuel Asanad https://orcid.org/0000-0002-7556-0155

Article

Publisher ID: 10.1177_2515841420950508

DOI: 10.1177/2515841420950508

PMC ID: 7457690

PubMed ID: 32923939

SO-VID: 1389a617-3399-4c8f-9e1d-11cbdfdc203e

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This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 13 March 2020

Date accepted : 13 July 2020

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cover-date January-December 2020

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Keywords: alzheimer’s disease,dominant optic atrophy,erythrocyte mediated angiography,glaucoma,leber’s hereditary optic neuropathy,optic neuropathy,optical coherence tomography angiography,parkinson’s disease,retinal blood flow,schizophrenia,vasomotion,wolfram syndrome

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Keywords: alzheimer’s disease, dominant optic atrophy, erythrocyte mediated angiography, glaucoma, leber’s hereditary optic neuropathy, optic neuropathy, optical coherence tomography angiography, parkinson’s disease, retinal blood flow, schizophrenia, vasomotion, wolfram syndrome

OCTA in neurodegenerative optic neuropathies: emerging biomarkers at the eye–brain interface

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Most cited references 84

Alzheimer's disease and Parkinson's disease.

A review of optical coherence tomography angiography (OCTA)

Microvascular network alterations in the retina of patients with Alzheimer's disease.

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